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EXHIBIT 1A(5)(f)
PEOPLES BENEFIT LIFE INSURANCE COMPANY
Home Office located at: 4333 Edgewood Road N.E., Cedar Rapids, Iowa 52499
A Stock Company
(Hereafter called the Company, we, our or us)
(800)866-6007
GUARANTEED INSURABILITY BENEFIT RIDER
This extra benefit rider, attached to and made a part of the policy, provides as
described below, options to purchase additional insurance without evidence of
insurability.
We agree:
1. To let you buy a policy or increase your current Specified Amount on the
life of the Insured on a regular or alternate option date. We will not
ask for evidence of insurability.
2. To pay your beneficiary the amount of insurance provided by this rider
if the Insured dies during the three-month period prior to an alternate
option date.
REGULAR OPTION DATES
Regular option dates will be the policy anniversaries following the Insured's
22nd, 25th, 28th, 31st, 34th, 37th and 40th birthdays.
ALTERNATE OPTION DATES
Alternate option dates will be three months after each of the following events
which occur after the date of this rider:
1. The marriage of the Insured.
2. The birth of a child to the Insured and the Insured's spouse.
3. The legal adoption of a child by the Insured.
4. The Insured's graduation from a 4 year college.
If you buy a policy on an alternate option date, we will cancel the next regular
option which has not already been cancelled. However, you may buy a new policy
on each alternate option date even though all regular options have been
cancelled.
If more than one child is born at the same time, or if the Insured adopts more
than one child at a time, we will allow you to buy more than one policy on the
same alternate option date. We also may allow you to buy one policy equal to the
maximum amount of this rider, as shown on page 3, multiplied by the number of
children.
The number of regular option dates to be cancelled will be equal to the number
of policies purchased, or if one policy is purchased, the number of policies
that would have been purchased if they had not been combined.
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THE CONTRACT
In this rider, "policy" means the policy in which you have requested that this
rider be included. "Page 3" means page 3 of the policy.
This rider is issued in consideration of the application and the payment of
premiums as provided. The amount of premium and the premium-paying period for
this rider are shown on page 3.
The Insured is the person shown as the Insured on Page 3.
This rider is a part of the policy. All provisions of the policy which are not
inconsistent with the provisions of this rider apply to this rider. This rider
will not increase the guaranteed values of the policy, if any.
Whenever premiums are waived under the policy, premiums shall likewise be waived
under this rider.
INSURANCE
We will pay your beneficiary the insurance death benefit provided by this rider
when we receive proof that the Insured died during the three-month period before
an alternate option date. The amount of the death benefit will be the maximum
amount that could have been bought on that option date. The death benefit will
be added to the death benefit of the policy.
THE NEW POLICY
NEW POLICY
New issue of the plan you select or an increased coverage on your existing plan.
AMOUNT OF NEW POLICY
The face amount for each new policy may not be less than the minimum amount or
greater than the maximum amount of this rider, as shown on page 3. The new
policy must be within the established issue limits for the plan you select.
PLAN
The new policy may be on any level premium whole life or endowment plan being
issued by us on the option date on a person of the Insured's age, except a plan
providing coverage of more than one person or including an option to purchase
additional insurance. We may include in the new policy any exclusion included in
this policy or which we are including in policies being issued on the option
date on persons of the Insured's sex and age who are in a standard risk class.
The new policy will not include a waiver of premium rider or an accidental death
benefit rider unless the Insured submits evidence of insurability satisfactory
to us at the time of issue of the new policy.
PREMIUMS
Premiums for the new policy will be for the same class of risk as for this rider
and for the Insured's age and sex.
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APPLICATION
You must apply for the new policy and pay the first premium. If an alternate
option is being elected, we must receive the application by the option date. If
a regular option is elected, we must receive it by the option date or within
sixty days before the option date.
If an alternate option is being exercised, you must give proof satisfactory to
us of the marriage, birth, adoption or graduation.
OWNER AND BENEFICIARY
The owner and beneficiary of the new policy will be as requested in the
application for the new policy.
POLICY DATE
If a regular or alternate option is elected, the date of the new policy will be
the option date. Insurance provided by the new policy will be effective on the
date of the new policy if the Insured is then living.
UNDERWRITING SAVINGS CREDIT
We will allow a credit when you buy each new policy. The credit will not be less
than $5, plus an additional $1 for each full $1,000 by which the face amount of
the new policy exceeds $5,000. We will apply the credit to reduce the first
premium for the new policy.
RIDER DATE
Rider months, years and anniversaries are measured from the rider date. The
rider date is the policy date unless a different rider date is shown in the
policy. When used in the rider, "date of issue" means the rider date.
INCONTESTABILITY
This rider is subject to the Incontestability provisions of the policy. However,
the contestable period shall, as far as this rider is concerned, be measured
from the date of issue of this rider.
TERMINATION
This rider will terminate on the earliest of the following dates:
1. The anniversary following the Insured's 40th birthday.
2. The date this rider or the policy lapses for failure to pay a premium.
3. The date the policy becomes paid-up, expires, matures as an endowment or
otherwise terminates.
4. The date a Nonforfeiture Option under the policy, if any, becomes
effective.
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You may terminate this rider by written request.
Termination will not affect an alternate option or the term insurance resulting
from a marriage, birth, adoption, death or graduation which occurred before this
rider terminated.
Signed for us at our home office.
/s/ [SIG] /s/ BART HERBERT JR.
SECRETARY PRESIDENT
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